This study longitudinally followed 42 children born prematurely from 5 to 7 years of age employing an inter-disciplinary approach. The mean birthweitht was 1143g, and the mean gestational age, 29 weeks. More than 80 percent of the subjects were either the first or second born. Over 20 percent of the subjects exhibited apparent death, and hyperbilirubinemia, apnea, transient polypnea, retrolental fibroplasia were among major complications. The subjects' gross motor skills were appropriate for age, but the development of the inhibitory system from the prefrontal and supplementary motor areas was delayd. Intellectual assessment revealed that the mean IQ was below average at age 5, but IQs of over 90% of the subjects reached the age appropriate level at age 7. Variabilities in scores across subtests diminished with age, and the subjects with discrepan es between PIQ and VIQ also decreased in number with age. About 70% of the subjects were within normal in language skills at age 5, with abo
… Moreut 10% showing apparent language delays. Articulatory skills improved with age, and no subjects showed articulatory deficits at age 7. Personality assessment yielded relatively low scores for activity level and ego autonomy, and 30-50% of the subjects exhibited difficulties in motor coordination, attention, tenacity, and social skills. However, with support from care givers and instructors, their adaptation to a day care or kindergarten improved. With respect to adaptation to school, 16 subjects were judged as normal, 12 as LD suspects, and 6 as intermediate. It was suggested that individual assessment is necessary to provide prematurely born children with services which meet their educational needs.小児神経学的検査では、粗大運動の発達は満期産出生児と差がなく、前頭前野や補足運動野からの抑制系の発達に遅れを認めた。知能検査では、5歳時には正常発達の平均に達せず、7歳時に9割強が平均以上に上昇、下位検査間のバラツキがなくなり、5歳時に見られた言語性の知能と動作性知能の有意差(3割)は7歳時には半減、しかも8名が知的に問題があった。言語発達は、5歳時に正常発達は7割で、言語発達が遅延しているものが各年齢1割強、構音は年齢毎に成熟し、7歳時にはほぼ問題がなくなり、7歳までcatch-upが進んでいた。幼稚園・保育園への適応に関しては、性格検査では活動性と自我・自律性が低く、約3〜5割に運動協応、集中力、持続力、社会性に問題がみられたが、担任教師の細やかな支援により、著しい成長がみられた。学校への適応(小1)については、普通群(知的な問題もなく学校・家庭生活でもさしたる問題もないもの)は16名で、学習障害(LD)サスペクト群は12名で、中間群(LD値、教師の判断した問題行動、知能検査のいずれか一つに問題があり、他は問題のないもの)は6名で、5割強に問題があった。公教育の場では子ども一人一人のニーズに応じた個別の教育計画を立案実行していくことが指向されるようになってきたが、低出生体重児の教育についても、個別的に教育内容を検討し、子の負担を減じていくことを実現していくことが必要とされる。また、今後、対象児を追跡していくことが必要である。 Less